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Gastrointest Endosc. 2019 Apr;89(4):782-788. doi: 10.1016/j.gie.2018.08.030. Epub 2018 Aug 25.

Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study.

Author information

1
Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
2
Johns Hopkins University, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
3
Division of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
4
Johns Hopkins Weight Management Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
5
Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Abstract

BACKGROUND AND AIMS:

Endoscopic sleeve gastroplasty (ESG) reduces the gastric lumen to a size comparable with that of laparoscopic sleeve gastrectomy (LSG). However, there is a paucity of research comparing outcomes between the 2 procedures. Our study compared the 6-month weight loss outcomes and adverse events of ESG with LSG in a case-matched cohort.

METHODS:

We retrospectively reviewed prospectively collected data for patients undergoing ESG or LSG at a single academic center. Weight was recorded at 1 and 6 months postprocedure, and percent total body weight loss (%TBWL) was calculated. Adverse events and new-onset Gastroesophageal Reflux Disease (GERD) were also recorded.

RESULTS:

A total of 54 ESG patients were matched with 83 LSG patients by age, sex, and body mass index. The proportion of patients with GERD at baseline was similar in the 2 groups (16.7% in ESG group vs 25.3% in LSG group, P = .27). At the 6-month follow-up, %TBWL (compared with baseline) was significantly lower in the ESG group compared with the LSG group (17.1% ± 6.5% vs 23.6% ± 7.6%, P < .01). ESG patients had significantly lower rates of adverse events compared with LSG patients (5.2% vs 16.9%, P < .05). New-onset GERD was also significantly lower in the ESG group compared with the LSG group (1.9% vs 14.5%, P < .05).

CONCLUSIONS:

ESG, a minimally invasive same-day procedure, achieved less weight loss at 6 months than LSG, with the caveat that LSG caused more adverse events and new-onset GERD than ESG.

PMID:
30148991
DOI:
10.1016/j.gie.2018.08.030

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